OLYMPIA – One of Washington’s 39 counties is still without an company willing to offer individual medical insurance plans to its residents next year, and some conditions that are causing rates to rise also prompt companies to pull out of rural counties, lawmakers were told Monday.

Insurance Commissioner Mike Kreidler said he was still talking with insurance companies in hopes of convincing one to offer individual coverage plans in Klickitat County, where about 1,000 people now have those plans. Premera recently agreed to sell individual plans in Grays Harbor County, which was also without a carrier after all proposals for 2018 were filed earlier this month.

“There are some innate problems, unique to rural counties,” Kreidler told the House Health Care and Wellness Committee.

That includes populations that are declining or not growing as fast as urban areas, demographics that tend to be older and not as healthy, and fewer health care professionals, particularly specialists needed for networks the companies want to set up, he and other health care officials said.

It’s also not clear if the federal government will continue to provide subsidies for some people who buy individual policies through the health care exchange, they said. Removing the mandate to have insurance or pay a penalty could also convince younger, healthier people not to buy a plan.

“Sometimes it just doesn’t make business sense to do business in a county,” Meg Jones, executive director of the Association of Washington Healthcare Plans, an industry group.